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Monterey Peninsula College training device mimics variety of ailments for nursing students

Thursday, June 23rd, 2011

Herald Staff Writer

Monterey Peninsula College nursing students Donna Santos, Chelsea Schuh, Kristin Paladino and Hilary Ryan huddle with instructor Patricia Nervino to discuss a recently admitted patient.

“Stanley Kowalski is 83-year-old with congestive heart failure. His BP is 150/80, his heart rate 104,” Nervino reads from a green chart. “He’s not describing any pain … he hasn’t voided … has not been seen out of bed. He’s on a low-sodium diet. He’s full-code and is a little hard of hearing.”

The students discuss the patient’s information and divvy up the work ahead. One will take his vital signs, one will order his medications, one will document what takes place. When the division of labor is established, they approach the patient.

Kowalski is lying on the bed, his chest rising and falling rhythmically, a hollow sound coming from his open mouth as he breaths. He’s blinking, a sign that he’s awake.

After washing their hands, Santos and Ryan greet the patient.

But the voice that responds doesn’t come from his mouth. It comes from behind a curtain, from the instructor who is working with the nursing students on bedside manners, clinical history and appropriate treatment.

Kowalski is a robot with rosy, rubber skin and the capacity to cough, cry and gag. From a nearby computer, trainers can manipulate its vital signs to simulate cardiac arrest or any emergency that would send medical teams scrambling — and test students’ abilities to react to life-threatening situations.

“We can have any scenario,” said Nervino. “The beauty of this is we can have all the students go through the same scenario,” something that could not be duplicated at a hospital.

Students at the Maurine Church Coburn School of Nursing have been training with robots in the simulation lab since 2007. But a recent gift of $115,000 by an anonymous donor to Community Hospital of the Monterey Peninsula has made an upgrade possible. The two new robots are wireless — which means they can be brought into the classroom and other settings. Instructors say they are easier to operate and are more realistic than their predecessors.

The nursing school was established more than 25 years ago in partnership with Community Hospital, so collaborations between the institutions are frequent.

Students begin doing clinical practice four months into the two-year program, but the study groups are larger than those using robots. Patients that students visit in clinical studies may not have the variety of ailments a robot can display. Situations that students haven’t experienced can be created using robots.

“Things can go wrong,” said Santos, who is 24. “… Here, they make them go wrong.”

There are other advantages. There is no risk of endangering anyone’s life and students can take on different roles in the teams and put different skills to the test in the same scenario.

They get a chance to practice their bedside manners. Patients require answers, can be testy and instructors try to be as realistic as possible.

“Have you seen my wife?” Nervino asks, taking on Kowalski’s role. “Why do you have to do that again?”

After receiving a doctor’s instructions for medication over the phone, Schuh is told by instructor Julie Bryan to be more assertive.

“You don’t say ‘May I read (the instructions) back,'” Bryan tells Schuh. “There can be no miscommunication. That’s why we say ‘I’m going to read it back to you.’ Doctors are used to it now.”

Students get to practice in the simulation lab four or five times a year. After each episode, they can watch a video of their performance and review the scenario overall. For them, the simulation lab is just as valuable as their visits to the hospital.

“They won’t know how this experience will help them until they go,” Nervino said. “Once they’re out there, they’ll say ‘I remember what we did as a team, now I can do it again.'”

Claudia Meléndez Salinas can be reached at 753-6755 or cmelendez@montereyherald.com.